If there is a graceful way into this, I’m not finding it right now. That being the case, I’m just going to back myself in here a few moments at a time.
it’s gross so… You’ve been warned. ?
I wet myself today. That’s it. That’s the drama. Nothing serious, sort of. Not great of course, better not to be a habit.
“30 years ago,” my urologist once said, “kidney failure was the leading cause of death among quadriplegics.” I assume it’s true. Paralysis, particularly for quadriplegics, slams right into the bowel and bladder function of the body, bringing their ordinary operation to a halt. Without material interference from a capable quadriplegic or some other loving hands, the bladder in this case will just keep filling up and create a back pressure on the ureters and up into the kidneys eventually.
Repeated assaults of this nature and eventually the resilience of the kidneys weakens and problems set in.
Not knowing this when I initially left the hospital 17 years ago, that was exactly how I managed my bladder. An external catheter to catch the runoff and I would just wait until the system backed up enough that my body would shudder, dysreflexia set in, the sphincter would spasm at the end of the urethra, and pressure would be released temporarily as urine drained from the bladder.
Nothing pleasant about it but at the time I didn’t know a better way. Eventually I learned. We learned, myself and those around me that is.
Today I have a suprapubic catheter entering through the stoma just below my navel. The bladder itself doesn’t even fill in this case, as any urine that can make the opening to the catheter just pours out into the drainage bag either at my bedside or attached to my leg during the day. That is how it works when all goes well.
Of course, the tube of the catheter can become pinched, or blocked, or as was the case today, the bag on the end and simply become all the way full. When that happens, the line fills next, then the bladder, then pressure on the ureters. I’m fairly confident that this is when I begin to feel the situation.
Autonomic dysreflexia sets in and I feel a sweat and a cognitive decline. My nervous system goes into a low-grade panic mode that fortunately does not subsume my emotions or attitude. If there is someone around, I’ll call out and we can address this simply enough. Just empty the drainage bag.
Today there was no one around.
The sensation came once.
Autonomic dysreflexia is interesting in the sense that it’s kind of a whole body experience that doesn’t necessarily point to any one thing in particular. For example, while this sensation may, in a given instance, be pointing to an overfull bladder, it might just as easily be a thorn in my leg, or a gas bubble in my abdomen or bowel. The condition of autonomic dysreflexia is simply the body responding to some discomfort not addressed by the individual’s conscious nervous attention. One signal, many potential messages.
I’ve often likened it this way: imagine if your toaster, your doorbell, your alarm clock, your telephone, and your smoke alarm all used one speaker and made the same sound.
As I said, the sensation came once. I had a feeling I knew what was going on, but hey – maybe just gas. Either way, it will pass. Of course if it’s the bladder that means I’ve probably bypassed the catheter and leaked through the urethra.
A few minutes later, the sensation passed.
A few minutes later, it returned. My confidence in the diagnosis was growing.
A few minutes later, the sensation passed.
A slight telltale order… Just passing.
I sent a text to the eight people I knew might possibly be in earshot and have the fortitude to help me address at least the surface of the issue:
“Just having a little leg bag issue and wondering if anyone is in the neighborhood :-)”
The nearest was in traffic, 35 minutes away.
Surrendering, knowing that my capacity to focus was compromised, I managed to complete the task I was working on (creating a PDF digital book of January’s entries from this journal.) Beyond cutting and pasting, I was pretty clear I would be useless to any more substantial task, such as that of writing this entry.
I made do. [Is that the correct “do?”] Internet says yes.
To make a long story short, when Caitlin arrived home from her long day at the seminar and two hours in traffic, there I was waiting, a minor crisis be addressed. We are good in these waters and she easily made her way into the house and to the relief of pressure in my drainage system.
Then the question of timing… I’m almost certainly sitting in some amount of urine right now. It could be slight, or more substantial. We won’t know until going to the process of preparing the bed to land me and inspect the situation. It may be nothing, or simple wipe down, more likely perhaps a shower. Timing.
To be done once pressure was relieved: let Caitlin exhale from the road; write this journal entry; eat dinner; inspect and clean any urinary mess; evaluate and likely take shower; bowel program; lights out. Not necessarily in that order.
Moving from chair to bed, bed to chair, cleaning and dressing, these will take time. My skin has been sitting in urine likely to some degree for 90 minutes or so. Where’s the trade-off? I don’t know. Effort, time, health… Each of these elements are likely not substantially influenced one way or another.
It’s a little gross, I guess I’ll probably just eat dinner and make my way to the rest now.
Thanks for joining me on this little journey of discomfort.
Today was otherwise good, lots of clerical kinds of issues teased along, nothing serious resolved, but nothing seriously urgent either. A little creativity at the end makes for a pleasant topping.
God gets to know things, we just get to ask questions…